- Hepatitis A is a virus found in human faeces (poo).
- It’s normally passed on when a person eats or drinks contaminated food and water.
- It’s also a sexually transmitted infection (STI) passed on through unprotected sexual activities, particularly anal sex. You can also get it if you share contaminated needles and syringes.
- Hepatitis A can be prevented by being careful where you eat and drink, practising safer sex, never sharing needles and syringes, and/or having a hepatitis A vaccination.
- A simple blood test carried out by a healthcare professional will show whether you have hepatitis A.
- There is no treatment for hepatitis A – it usually clears up on its own.
What is hepatitis A?
Hepatitis A (also known as hep A or HAV) is part of a group of hepatitis viruses that attacks the liver.
Hepatitis A is found in human faeces (poo) and is commonly passed on by eating or drinking contaminated food and water. It’s more common in places with poor sanitation and hygiene conditions and a lack of clean water. However, it can also be passed on through unprotected sex and via sharing needles.
Hepatitis A is not usually serious and clears up on its own after 10 to 14 days. However, hepatitis A has many of the same symptoms as more serious types of hepatitis infections – such as hepatitis B or C – so it’s important to get tested.
A vaccine for hepatitis A is available for people living in or visiting countries where it is common, or for groups at a greater risk of getting the virus, such as men who have sex with men, people who inject drugs, and people who have lots of sexual partners.
How do you get and prevent hepatitis A?
The hepatitis A virus needs to get from human poo into the mouth to infect someone. You only need to be in contact with small amounts of poo to become infected.
Contaminated food and water
Hepatitis A is most commonly passed on by eating food prepared by someone with the virus whose hands have not been washed properly. You can also get it by drinking dirty water (including ice cubes) and by eating raw or undercooked shellfish from dirty water.
You can protect yourself by:
- Washing your hands each time you go to the toilet, before you prepare or eat food, after coughing or sneezing, or handling rubbish or other dirty items.
- Peeling and washing all your fresh fruit and vegetables; avoiding raw or undercooked meat and fish; avoiding all drinks if you’re not sure if they’re safe – with or without ice.
- If tap water isn’t safe and bottled water isn't available, boil tap water before drinking it.
- People living in places with poor sanitation and hygiene are at a greater risk of hepatitis A infection. You may also be exposed to hepatitis A through your work, for example, sewage workers, staff in institutions where levels of personal hygiene may be poor (such as a homeless shelter), people working with animals that may be infected with hepatitis A and daycare centres.
Sex and dirty needles
Hepatitis A can also be passed on through sex without a condom or dental dam with someone who has the virus, even if they don’t have symptoms
In particular, via anal sex, fingering, rimming, fisting, or exploring the area around the anus (bottom) with your fingers, mouth or tongue. Touching used condoms, sex toys and douching equipment that have been in someone else’s anus (bottom) can also pass the virus on.
You can protect yourself by:
- Knowing the status of your sexual partners.
- Using a new male (or external) or female (or internal) condom or dental dam every time you have vaginal, anal or oral sex.
- Using a new dental dam or latex gloves for rimming and fingering (exploring your partner’s anus with your fingers, mouth or tongue) or using latex gloves for fisting.
- Covering sex toys with a new condom and wash them after use.
- Avoiding sex that involves contact with faeces (poo).
- Washing your hands after touching someone’s anus or handling used condoms and sex toys.
- Using a new condom for every sexual partner and having regular STI tests.
- Having the hepatitis A vaccine (where available) if you’re in close contact with someone with hepatitis A or if you’re in a high-risk group. This can also be provided as prophylaxis if provided within two weeks of exposure.
Sharing contaminated needles and syringes during recreational drug use can also pass hepatitis A on. Make sure you use new injecting equipment every time you inject drugs.
Pre-exposure prophylaxis (PrEP) does not prevent you from getting hepatitis A, nor does the contraceptive pill or other forms of contraception (apart from condoms and dental dams).
What are the symptoms of hepatitis A?
Many people with hepatitis A don’t have any symptoms. If symptoms do develop, you’ll usually notice them around two to four weeks after infection. These symptoms will usually pass within two months.
- flu-like symptoms, including tiredness, a fever and aches and pains
- loss of appetite
- feeling and/or being sick
- pain in the upper right part of your tummy (abdomen)
- dark urine and pale faeces (poo)
- yellowing of the skin and eyes (jaundice)
- itchy skin.
How do you test for hepatitis A?
If you’ve been in contact with someone who has had hepatitis A, are at risk of getting hepatitis A, or if you start to have symptoms – it’s a good idea to talk to a healthcare professional. A simple blood test will show whether you have the virus.
If you test positive, they may also do another type of blood test to check if your liver is working properly. You should also be tested for other STIs.
It’s important that you tell people you live with or have close contact with, and your recent sexual partner/s so they can also get tested. Many people who have hepatitis A don’t notice anything wrong, and by telling those you’re in close contact with you can help to stop the virus being passed on.
How is hepatitis A treated?
Unlike other types of viral hepatitis, hepatitis A rarely causes long-term liver damage and doesn't become a long-term (chronic) illness. There isn’t a specific treatment for hepatitis A, and most people will recover fully within one to two months. Usually, symptoms are managed at home with plenty of rest; and painkillers and/or medication to help with itchiness, nausea or vomiting may be prescribed.
Occasionally hepatitis A can last longer and, in rare cases, it can be life-threatening if it causes the liver to stop working properly (liver failure).
Whether you’ve got symptoms or not, don’t prepare food for others or have sex until a healthcare professional tells you that you’re no longer infectious.
Once you’ve recovered from hepatitis A you’re immune – this means you can’t get it again. But you can get other types of hepatitis.
Hepatitis A and HIV
For people living with HIV, your risk of getting hepatitis A is the same as people not living with HIV. If you do get hepatitis A, your viral load is likely to increase because your immune system is weaker. This will make you more likely to pass on HIV if you have sex without a condom.
Some people living with HIV may stay sick with hepatitis A for longer than people who haven’t got HIV.
Many antiretroviral drugs are processed in the liver. For people with prolonged or severe hepatitis A, your doctor may decide to adjust your treatment.
If you’re living with HIV or at risk of HIV, for example, if you’re a man who has sex with men or if you sell sex or use drugs, ask your healthcare professional if you should have a hepatitis A vaccination.
If you’re worried about HIV infection, find out everything you need to know in our HIV Transmission and Prevention section
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